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Clinical practice guideline adherence before and after implementation of the HEARTFELT (HEART Failure Effectiveness &

Patricia C Dykes1, Kim Acevedo, Jodie Boldrighini

  • 1Partners HealthCare System, Boston, MA, USA. pdykes@partners.org

The Journal of Cardiovascular Nursing
|September 6, 2005
PubMed

Insights

The HEART Failure Effectiveness & Leadership Team (HEARTFELT) intervention improved clinician adherence with electronic health record documentation and patient self-management education for heart failure (HF). Medical intervention adherence showed no significant change.

Area of Science:

  • Cardiology
  • Healthcare Management
  • Clinical Practice Guidelines

Background:

  • Adherence to American College of Cardiology/American Heart Association practice guidelines for heart failure (HF) is crucial for optimal patient outcomes.
  • Integrating evidence-based practices into community hospital settings remains a challenge.

Purpose of the Study:

  • To evaluate the impact of the HEART Failure Effectiveness & Leadership Team (HEARTFELT) intervention on clinician adherence to HF practice guidelines.
  • To assess changes in adherence before and after HEARTFELT implementation.

Main Methods:

  • A quasi-experimental, pretest/posttest design with an untreated control group was used.
  • The intervention included electronic medical record pathways, evidence access, self-management tools, and feedback.
  • Data were analyzed using parametric and nonparametric statistical methods.

Main Results:

  • HEARTFELT significantly improved clinician adherence with electronic health record documentation of self-management categories (P = .000).
  • Adherence with providing written self-management education to patients at discharge significantly increased (P = .000).
  • No significant differences were observed in adherence to medical interventions (P = .39).

Conclusions:

  • The multifaceted HEARTFELT intervention shows promise for integrating evidence into clinical practice at the point of care.
  • It has the potential to reduce practice variation and improve outcomes for heart failure patients.
  • Further exploration of integration methods in community hospitals is warranted.

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